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探索在急性心理健康病房中使用随身佩戴的摄像头:一项试点干预的混合方法评估。

Exploring the use of body worn cameras in acute mental health wards: a mixed-method evaluation of a pilot intervention.

机构信息

Mental Health Nursing, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London, SE5 8AF, UK.

Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Mental Health Nursing, King's College London, London, UK.

出版信息

BMC Health Serv Res. 2024 May 29;24(1):681. doi: 10.1186/s12913-024-11085-x.

Abstract

BACKGROUND

Body worn cameras (BWC) are mobile audio and video capture devices that can be secured to clothing allowing the wearer to record some of what they see and hear. This technology is being introduced in a range of healthcare settings as part of larger violence reduction strategies aimed at reducing incidents of aggression and violence on inpatient wards, however limited evidence exists to understand if this technology achieves such goals.

AIM

This study aimed to evaluate the implementation of BWCs on two inpatient mental health wards, including the impact on incidents, the acceptability to staff and patients, the sustainability of the resource use and ability to manage the use of BWCs on these wards.

METHODS

The study used a mixed-methods design comparing quantitative measures including ward activity and routinely collected incident data at three time-points before during and after the pilot implementation of BWCs on one acute ward and one psychiatric intensive care unit, alongside pre and post pilot qualitative interviews with patients and staff, analysed using a framework based on the Consolidated Framework for Implementation Research.

RESULTS

Results showed no clear relationship between the use of BWCs and rates or severity of incidents on either ward, with limited impact of using BWCs on levels of incidents. Qualitative findings noted mixed perceptions about the use of BWCs and highlighted the complexity of implementing such technology as a violence reduction method within a busy healthcare setting Furthermore, the qualitative data collected during this pilot period highlighted the potential systemic and contextual factors such as low staffing that may impact on the incident data presented.

CONCLUSION

This study sheds light on the complexities of using such BWCs as a tool for 'maximising safety' on mental health settings. The findings suggest that BWCs have a limited impact on levels of incidents on wards, something that is likely to be largely influenced by the process of implementation as well as a range of contextual factors. As a result, it is likely that while BWCs may see successes in one hospital site this is not guaranteed for another site as such factors will have a considerable impact on efficacy, acceptability, and feasibility.

摘要

背景

随身摄像机(BWC)是一种可固定在衣物上的移动音频和视频捕捉设备,可让佩戴者记录他们所见所闻的部分内容。这项技术正在一系列医疗保健环境中推出,作为旨在减少住院病房内攻击和暴力事件的更大减少暴力策略的一部分,然而,目前几乎没有证据表明该技术能够实现这些目标。

目的

本研究旨在评估 BWC 在两家精神科住院病房的实施情况,包括对事件的影响、对工作人员和患者的可接受性、资源使用的可持续性以及管理这些病房 BWC 使用的能力。

方法

该研究采用混合方法设计,在试点实施 BWC 之前、期间和之后的三个时间点,通过比较定量措施(包括病房活动和常规收集的事件数据),对一家急性病房和一家精神病重症监护病房进行了比较,同时对试点前后的患者和工作人员进行了定性访谈,使用基于实施研究综合框架的框架进行了分析。

结果

结果显示,在这两个病房中,BWC 的使用与事件的发生率或严重程度之间没有明显的关系,BWC 的使用对事件发生率的影响有限。定性研究结果表明,对 BWC 的使用存在混合看法,并强调了在繁忙的医疗保健环境中实施这种技术作为减少暴力方法的复杂性。此外,在试点期间收集的定性数据突出了可能影响呈现的事件数据的潜在系统和环境因素,例如低人员配置。

结论

本研究阐明了在精神卫生环境中使用 BWC 作为“最大限度提高安全性”工具的复杂性。研究结果表明,BWC 对病房事件发生率的影响有限,这很可能在很大程度上受到实施过程以及一系列环境因素的影响。因此,虽然 BWC 在一个医院站点可能取得成功,但这并不能保证另一个站点也能成功,因为这些因素将对疗效、可接受性和可行性产生重大影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18de/11138092/0a09c2ccb65b/12913_2024_11085_Fig1_HTML.jpg

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